INSR ADDL SUBR
LTR INSR WVD
DATE (MM/DD/YYYY)
PRODUCER CONTACT
NAME:
FAXPHONE
(A/C, No):(A/C, No, Ext):
E-MAIL
ADDRESS:
INSURER A :
INSURED INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
POLICY NUMBER
POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY) (MM/DD/YYYY)
COMMERCIAL GENERAL LIABILITY
AUTOMOBILE LIABILITY
UMBRELLA LIAB
EXCESS LIAB
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
AUTHORIZED REPRESENTATIVE
INSURER(S) AFFORDING COVERAGE NAIC #
Y / N
N / A
(Mandatory in NH)
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
EACH OCCURRENCE $
DAMAGE TO RENTED $PREMISES (Ea occurrence)CLAIMS-MADE OCCUR MED EXP (Any one person) $
PERSONAL & ADV INJURY $
GENERAL AGGREGATE $GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG $
$
PRO-
OTHER:
LOC JECT
COMBINED SINGLE LIMIT
$ (Ea accident)
BODILY INJURY (Per person) $ANY AUTO
OWNED SCHEDULED BODILY INJURY (Per accident) $AUTOS ONLY AUTOS
AUTOS ONLY
HIRED PROPERTY DAMAGE $AUTOS ONLY (Per accident)
$
OCCUR EACH OCCURRENCE $
CLAIMS-MADE AGGREGATE $
DED RETENTION $ $
PER OTH-
STATUTE ER
E.L. EACH ACCIDENT $
E.L. DISEASE - EA EMPLOYEE $
If yes, describe under
E.L. DISEASE - POLICY LIMIT $DESCRIPTION OF OPERATIONS below POLICY
NON-OWNED
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s).
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
CERTIFICATE HOLDER CANCELLATION
© 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORDACORD 25 (2016/03)
ACORDTM CERTIFICATE OF LIABILITY INSURANCE
National Fire Insurance Co. of Hartford
Continental Insurance Company
American Casualty Company of Reading PA
Indian Harbor Insurance Company
Great American Fidelity Insurance Co.
11/25/2025
USI Insurance Services LLC-CL
3190 Fairview Park Drive Suite 400
Falls Church, VA 22042-4546
703 698-0788
Austin Bowen
703 698-0788 610 362-8377
[email protected]
Highstreet IT Solutions, LLC
8201 Greensboro Drive
Suite 530
Mc Lean, VA 22102
20478
35289
20427
36940
41858
A X
X
X X
5093379522 07/06/2025 07/06/2026 1,000,000
1,000,000
15,000
1,000,000
2,000,000
2,000,000
B
X X
5093379519 07/06/2025 07/06/2026 1,000,000
B X X
X 10000
5093379486 07/06/2025 07/06/2026 9,000,000
9,000,000
C
N
1,000,000
1,000,000
D
E
Cyber Tech E&O
Excess Cyber
MTP904905200
CYXF3617700
07/06/2025
07/06/2025
07/06/2026
07/06/2026
$5,000,000
$5,000,000
** Workers Comp Information **
C 593379536 Eff Date: 07/06/2025 Exp Date: 07/06/2026
WC Each Accident Limit: $1,000,000
WC Policy Limit: $1,000,000
(See Attached Descriptions)
City of Bakersfield
1600 Truxton Ave.
Bakersfield, CA 93307
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#S51870128/M51870103
HIGHSITClient#: 1089300
JYREK
WC593379536 07/06/2025 07/06/2026 X
1,000,000
SAGITTA 25.3 (2016/03)
DESCRIPTIONS (Continued from Page 1)
WC Each Employee Limit: $1,000,000
Regarding work performed by the named insured, the City of Bakersfield, its mayor, council, officers, agents and employees are included as additional insureds per written contractual agreement for the terms and provisions of the general liability coverages. A waiver of subrogation is granted to the City of Bakersfield, its mayor, council, officers, agents and employees with respect to general liability and workers compensation, where required by written contract, subject to policy terms and conditions. provided.
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/C42/C52/C4f/C41/C44/C20/C4b/C4e/C4f/C57/C4c/C45/C44/C47/C45/C20/C4f/C46/C20/C4f/C43/C43/C55/C52/C52/C45/C4e/C43/C45 Workers Compensation And Employers Liability InsurancePolicy EndorsementWAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENTWe have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.Any person or organization for which the employer has agreed by written contract, executed prior to loss, may execute a waiver of subrogation. However, for purposes of work performed by the employer in Missouri, this waiver of subrogation does not apply to any construction group of classifications as designated by the waiver of right to recover from others (subrogation) rule in our manual.ScheduleAny Person or Organization on whose behalf you are required to obtain this waiver of our right to recover from under a written contract or agreement.The premium charge for the endorsement is reflected in the Schedule of Operations.All other terms and conditions of the policy remain unchanged.This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes effect on the Policy Effective Date of said policy at the hour stated in said policy, unless another effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy unless another expiration date is shown below.
WC 5 93379536Endorsement No: 6; Page: 1 of 1 Policy Page: 209 of 354Underwriting Company: American Casualty Company of Reading, Pennsylvania, 151 N Franklin St, Chicago, IL 60606 Form No: WC 00 03 13 (04-1984)Endorsement Effective Date: Policy No: Policy Effective Date: 07/06/2025Endorsement Expiration Date:
Copyright 1983 National Council on Compensation Insurance.